代写英国作业：国际肥胖健康风险和政策(2)

Integration and coordination of preventive, promotional, curative and rehabilitative measures The government of Nauru agreed that they could only support the older population through high medicine sta

Integration and coordination of preventive, promotional, curative and rehabilitative measures

The government of Nauru agreed that they could only support the older population through high medicine standards, sufficient medication in case of diabetes, free athletic classes, obesity warnings and specialized medicine treatments (20min 2011). The young generation gets additional education about unhealthy living styles, is supported with more opportunities and motivation to do sports and. The focus of the government therefore lays on trying to change the development of the future generations and alleviation of the present problems for the older generations. Extravagant measures, like the daily walk of the president are one of the things, which were implemented to raise awareness.

Decentralization of services

The decentralization is not relevant because of the very small size of the country.

2.2 Discussion of Financing Options of Social Health Protection in the Case of

Nauru

There are various ways that a social health insurance could be financed. This section of the paper will be explaining the various financing options, the various features of each of the options, how they work and then assess its feasibility in financing social health insurance policies in Nauru.

The various financing options the paper would examine are as follows: User fees, Prepayment scheme, Government budget and Private insurance. Besides that Social insurance and Micro-insurance are further options of financing, which will not be focused in the following discussion.

User Fees

This involves an “out-of-pocket” financing of health services. In other words, the people would have to pay out of their pocket and it is usually on an immediate basis. It has been argued overtime whether this form of financing is effective or not, and also whether it promotes the use of social health insurance. While some argued that it provides a measure to check over utilization of health services, some argued that it doesn’t encourage the poor (who are the most vulnerable to health risks) to use health services as it is usually too expensive for them to manage. Also, it doesn’t really protect people from risks as there is no insurance element.

With all the above mentioned, it is quite clear why this form of financing cannot be used in Nauru. In a country with 90% unemployment according to CIA fact book and with its citizens having no source of income, it will be impossible for them to pay for health services out of their pockets much less immediately.

Prepayment Scheme

Prepayment scheme as the name implies is the payment for a service in advance. This involves a payment of premium before the occurrence of the hazard. It has same features like the user fees except that it has an insurance element in that the users pay ahead of the occurrence of the hazard.

This also cannot work for the citizens of Nauru as most of them are unemployed so there is no way of making payments in installments. Also, most of the employed are working in the informal sector, which makes it even more difficult for pooling of funds.

Government Budget (Taxes)

The government can also get to finance health care policies. This is usually done by allocating a percentage of government budget to the health care sector. Also, it could be done through payment of tax by citizens to government but usually with subsidies. This form of financing acts as a balance between the rich getting health coverage and the poor getting coverage as well. This is so because it is cheaper, provides universal access with low administration costs and most importantly, more coverage at little or no costs.

The Nauru government has an annual budget of $AUD 35.6 million as reported by the UNICEF in 2002, as well as a total expenditure of $AUD 79 million, which brings its deficit to $AUD 49 million. With this huge deficit and 90% of her revenue coming from aid, the health sector remains under funded still even though a higher percentage of her budget goes to providing health services. Making it also almost impossible to singlehandedly provide good health services based on government funding.

Private Insurance

Private health insurance is a form of voluntary insurance taken out by users themselves for various reasons. It has been argued that private health insurance helps cater to needs of the rich which allows the government to focus on catering better to the needs of the poor with limited resources. Also, it helps to provide more choices to the consumers and acts as a catalyst to reforms and efficiency in public health insurance. Despite all of these advantages, it is still really expensive and even widens gap between the rich and poor. Moreover, it is a bit difficult to administrate.

Presently, there is no form of private health insurance in Nauru. This is no surprise as private health insurers usually invest where the profits are higher and also insure people with lowest vulnerability to risks. In Nauru, most of its people suffer from obesity and diabetes; thus, if there were to be any coverage by insurance, these two diseases have to be a main focus but private insurers won’t want to insure them as the probability of the risk occurring is really high.

3 Conclusions and Recommendation

The paper focused mainly on two pillars, which are assessment of the requirements of adequate health policies and financing options. Within the chapters 2.1 and 2.2., we could give evidence for a number of problems, of which inhabitants of Nauru suffers today. Those can be summarized by the following characteristics:

1. Country specific obstacles like the small size, small number of inhabitants, high number of unemployed people, as well as the high number of diseased people and mismanagement in the past.

2. Lack of self-responsibility

3. High dependency burdens

4. Budget constraints

These problems affect the health conditions of the country to large extend and worsen the situation of people who suffer from obesity but also support a large number of obesity incidence.

We must come to the conclusion that for the same reasons / problems, Nauru will not be able to deal with the problem in a proper way in the short and in the intermediate term. Also, it can be estimated, that Nauru will not be able to formulate adequate policies and strategies to address the needs of those people who already suffer from obesity as well as those who are in danger to come down with obesity.

Furthermore it is critical to find sufficient and sustainable sources how to finance the budget and especially a budget for health policies.

Even if the authorities are aware of the problem and have been implementing single strategies to fight against obesity, it lacks of a broad and sustainable implementation of concrete measures to address the problem.

Due to the requirements of adequate health policies, it can be stated, that Nauru is not able to improve the situation remarkably. At the moment, the awareness concerning a responsibility and especially self-responsibility of the Nauruan authorities to address the needs of a healthy population is not obvious. The major argument here is, that there is no transparency because of lack of adequate information.

In terms of financing options, Nauru has to look for other, maybe unconventional financing options e.g. selling the right for an arts project (film, book) because of the countries unique past or Nauru could initiate a crowd funding campaign, which offers adventure vacation for money. Besides that, Nauru should focus on financing options, which makes the country independent from single donor states like Australia, e.g. credit at the World Bank.